Indian governments have an abysmal record in providing healthcare. Among major economies, India has perhaps the most vulnerable population when it comes to dealing with health emergencies. Around 58% of total healthcare expenditure is borne by patients directly, without insurance or reimbursements. Since 2008, central governments have tried to address the problem through a cashless national health insurance scheme, RSBY, for economically vulnerable people. In a welcome move, health ministry plans improvements here by bundling RSBY with a few other schemes, and enhancing the extent of insurance cover. A well designed health insurance scheme is a key component of a social safety net.
Some states have taken upon themselves the responsibility of providing health insurance. But given the growing extent of labour mobility in India, there is a strong need for a national portable health insurance policy such as RSBY. RSBY, a centrally sponsored scheme where the Centre and states jointly pay the insurance premium, has had a mixed record. According to the government, only about 37 million families of the target group of 73 million have been covered by the scheme. Moreover, only 19 states have signed up to partner the Centre to fund RSBY. It’s critical, therefore, to use the experience of the last few years to improve the scheme.
